Tuesday, April 12, 2005

Patients Denied Organ Transplants for Taking Prescribed Methadone

Previously we've commented on the absurd practice of the criminal justice system demanding methadone patients on probation or parole, or seeking to participate in drug court, discontinue taking their prescribed medication or go to jail. Sadly, the same irrational demand to stop effective treatment is made by some organ transplant programs, that refuse to even consider a potential recipient until s/he has been detoxified for at least six months. This despite the fact that several papers have been written and published in peer-reviewed journals indicating transplant success rates that are essentially the same for methadone maintained patients and those with no history of any drug use. Go figure... !

Tuesday, April 05, 2005

Demanding Effective Treatment Be Stopped: What is the Rationale?

Everyone knows that opiate dependence is a terribly costly condition that is associated with enormous expense to society at large and great morbidity and mortality for the drug users. It has also been demonstrated consistently for 40 years that "treatment works," and no treatment has been proven as effective as methadone maintenance. And yet, we are aware of countless cases throughout the US where judges, prosecutors, probation and parole authorities have demanded that methadone maintained patients, regardless how successful their treatment has been, detoxify or be sent to jail. This applies regardless whether the alleged offense was committed while methadone was being prescribed, or before treatment was initiated. There is a firm policy signed by the three judges responsible for probation in Henry County Indiana: detox from maintenance or go to jail. A patient in Tazewell, Va., was given the same option; in her case she tried but her physician felt obliged to re-institute a higher dose of methadone toward the end of the detox process, which caused the judge to sentence her to three and a half years in prison. A patient in California was arrested for driving under the influence of alcohol, forced to detox as an alternative to prison, and within three months had died of an overdose of heroin.

The NYC "drug courts" have different criteria for eligibility, spelling out the precise dose of methadone that cannot be exceeded at the outset, and the time required for complete withdrawal.

So . . . can anyone suggest what the rationale is here? Why terminate successful treatment? Why incarcerate someone whose physician continues to prescribe a medication known for 4 decades to be associated with major benefits for patient and society alike? What are our criminal justice system leaders smoking?